This article is more than 5 years old. Information may no longer be current.
Adopt, adapt and adhere to lifestyle changes
How to help adult patients effectively manage chronic health conditions.
Click Here to Manage Email Alerts
In order for patients to effectively manage a chronic condition, such as diabetes, they most likely will need to adopt, adapt and adhere to one or more lifelong lifestyle changes. Clinicians and patients enter into a “teaching-learning” relationship when life-style changes that are critical to the patient’s well-being are necessary.
These lifestyle changes, which are summarized in the AADE-7 Self-Care Behaviors (see table 1), require that the individual learn a new skill (how to do it) and/or acquire new knowledge (what to do). Simply telling a patient what to do often does not result in the desired behavior change. Patients who do not heed advice and take no action are often referred to as noncompliant. For the clinician providing care, this is a frustrating situation.
|
|
Approach to learning
Understanding the adult learning process can provide clues about increasing the likelihood that your patients adopt, adapt and adhere to these lifestyle changes.
The field of adult learning is less than 40 years old. Malcolm Knowles was the first to theorize how adults learn and described adult learning as a process of “self-directed inquiry.” Knowles identified six characteristics of adult learners (see table 2).
Upon examination of these adult learning characteristics it becomes apparent that adult learning requires a collaborative and cooperative approach. The clinician must create a climate of mutual trust and cooperative learning. Simply telling a patient what he or she needs to do without acknowledging how and why adults learn something new is a recipe for failure and noncompliance.
A coaching/mentoring approach utilizing the following teaching strategies is considered more effective with teaching adults.
- Use open-ended questions to allow patients to tell you their story.
- Clarify expectations; permit push-back.
- Treat all questions and concerns with respect.
- Ask how they would like to receive information (hands-on, print, video, etc).
- Focus on direct application rather than general information.
- Show how new information can be immediately applied to current problems or situations.
|
|
All of these strategies require that the clinician be proficient in adult learning principles and allow time for meaningful interaction. Including diabetes educators as part of the team approach to help patients adopt, adapt and adhere to lifestyle changes supports the clinician, the care process and, most importantly, the patient.
Mary M. Austin, MA, RD, CDE, is Owner and President of The Austin Group, LLC in Shelby Township, Mich., and is an Endocrine Today Editorial Board member.